Chapter 14: Musculoskeletal System Flashcards
Abduction
movement away from the middle of the body
Adduction
movement towards the middle of the body
Active
movement of a joint completely solely by the individual performing the exercise
Alignment
configuration of the human skeletal structure in which the body is perfectly balanced
Allis Sign
used to assess for hip dislocation, primarily in order to test for developmental dysplasia of the hip
- known as Galeazzi test
Atrophy
loss of skeletal muscle mass
Barlow Maneuver
adducting a newborn’s hip towards the midline and apply pressure to see if the femoral head dislocates from the acetabulum
- screens for developmental dysplasia of the hlp
- perform ortolani maneuver to confirm diagnosis
Bilateral
having or relating to two sides; affecting both sides
Bouchard Nodes
hard, bony outgrowths or gelatinous cysts on the middle joints of fingers or toes
Carpal Tunnel
narrow, rigid passageway of ligament and bones at the base of the hand that houses the median nerve and the tendons that bend the fingers
Cervical Spine
bones, nerves, muscles, ligaments and tendons in the neck
Concave
an outline or surface that curves inward like the inside of a circle
Contracture
permanent tightening of tissue
Convex
an outline or surface curved like the outside of a circle
Crepitus
grating, crackling or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue
Deltoid
muscle, roughly triangular in shape, that stretches from the collarbone (clavicle) over the shoulder to the upper bone of the arm (humerus)
Dorsiflexion
movement of the foot (plantar) upward
Edema
swelling of soft tissues as a result of excess fluid accumulation
Extension
movement that increases the angle between two muscles or joints
External Rotation
muscular and joint movement that entails both circular movement and also movement away from the center of the body
Extremeties
limb or appendage of the body, particularly the hands and feet
Eversion
turning of a joint outward
Flexion
movement that decreases, or lessens, the angle between two muscles or joints
Gait
time interval between two successive steps while walking
Heberden Nodes
small fixed bump on the finger (usually the last joint of the finger); a calcified spur of the joint (articular) cartilage and is sign of osteoarthritis
Hyperextension
excessive joint movement in which the angle forced by the bones of a particular joint is opened, or straightened, beyond it’s normal, healthy, range of motion
Internal Rotation
motion around a center of rotation such that the angular motion vector points towards the midline of the body
Inversion
turning of a joint inward
Kyphosis
increased front-to-back curve of the upper spine
Lordosis
anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side
-excessive inward curvature of the spine that can cause pain and discomfort
Misalignment
incorrect arrangement or position of something in relation to something else
Nodules
small mass of rounded or irregular shape
Ortolani Maneuver
technique for reduction of hip dislocation, - using thigh flexion and abduction with anterior movement of the femoral head
Passive
movement requiring the patient to relax while the practitioner provides movement to the patient’s joints, muscles, tendons and ligaments
Phalens
diagnostic test for carpal tunnel
Plantar Flexion
Movement of the foot when it is bent at the ankle away from the body; accomplished by flexing muscles in the calf, ankle, and foot
Pronation
rotation of the forearm and hand so that the palm is down (and the corresponding movement of the foot and legs with the sole down)
Rotation
circular movement of a joint or muscle that allows the bodily part to move in a circular way
Scoliosis
disorder causing curvature in the back
Spinal Accessory (CN XI)
cranial nerve essential for neck and shoulder movement
Supination
when palms or forearm faces up; when walking weight tends to be more on the outside of foot
Swan-Neck Deformity
deformed position of the finger, in which the joint closest to the fingertip is permanently bend toward the palm while the nearest joint to the palm is bent away from it
Symmetry
quality of being made up of exactly similar parts facing each other or around an axis
Trapezius Muscle
allows tilting/turning the head and neck, shrugging the shoulders, and twisting the arms; elevates, depresses, rotates, and retracts the scapula, or shoulder blade
Ulnar Deviation
causes the joints in the wrist and hand to shift so the fingers bend toward the ulnar bone on the outside of the forearm
Unilateral
relating to, occurring on, or affecting only one side of an organ or structure, or of the body
What do you use a Goniometer for ?
to measure joint range of motion
What is the Lovett scale ?
tool used to grade muscle strength
- 0 (zero): no evidence of contractility
- 1 (trace): evidence of slight contractility
- 2 (poor): complete ROM with gravity eliminated
- 3 (fair): complete ROM with gravity (50% normal)
- 4 (good): complete ROM against gravity with some resistance
- 5 (normal): complete ROM against gravity with full resistance (100% normal)
What is spastic paralysis ?
involuntary contraction of muscles that occurs after a spinal cord injury or cerebrovascular accident (stroke)
- muscles are stiff, rigid, and contracted**
What is flaccid paralysis ?
lack of muscle tone or deep tendon reflexes after damage to lower motor neurons
What is internal rotation ?
turning the part toward midline
What is the external rotation ?
turning away from midline
What is opposition ?
touching thumb to each finger on same hand
What is structural scoliosis ?
lateral curvature of thoracic or lumbar vertebrae (structural)
- most often in adolescence and in females
- treatment includes a brace to prevent further progression of curvature
What is functional scoliosis ?
due to unequal leg length, muscle spasms, poor posture
- temporary change
- correct underlying problem to eliminate spinal curvature
How do you assess scoliosis ?
- forward flexion at the waist and rise slowly
- shoulders and iliac crests are unequal
What is kyphosis ?
excessive convexity of the thoracic spine
- hunchback posture
What are some causes of kyphosis ?
- aging
- poor posture
- Scheuermann’s disease (unknown cause- a developmental disorder of the spine)
- arthritis
- osteoporosis
- disk degeneration
- fractures
- cancer/cancer treatment
What is lordosis ?
excessive concavity of the lumbar spine
- stomach seems to protrude more
- more common in black children
What are the causes of lordosis ?
- obesity
- pregnancy
- osteoporosis
- benign (juvenile)
- achondroplasia (associated with short stature in dwarfism)
- kyphosis
What causes carpal tunnel syndrome ?
caused by pressure on the median nerve as it travels through the carpal tunnel
- because of repeated movements like typing, playing of the violin, pianists
What are some tests that diagnose carpal tunnel syndrome ?
- Tinel’s sign
- Phalen’s sign
What is Tinel’s sign ?
where you tap on the median nerve where it passes through Carpel Tunnel (at wrist)
- no pain or tingling is a negative test
What is Phalen’s sign ?
flex both wrists and press dorsal aspects against each other for 1 min
- if pain, numbness or tingling= positive for carpal tunnel
What is rheumatoid arthritis ?
chronic inflammatory, autoimmune disease (cause unknown)
- causes destruction of connective tissue
- synovial joints become inflamed causing swelling, which leads to deterioration of cartilage and erosion of bone surface
What are some risk factors of rheumatoid arthritis ?
- female (usual onset in 30s and 40s)
- viral infection trigger
- small framed and genetic predisposition
What is the onset of rheumatoid arthritis ?
- usually begins insidiously over several weeks to months
- however, can be sudden (24-48 hrs)
- progressive, with exacerbations & remissions
What are some symptoms of rheumatoid arthritis ?
- joint involvement is usually bilateral
- pain, edema, stiffness: fingers, wrists, ankles, feet and knees
What are some deformities of rheumatoid arthritis ?
- ulnar deviation
- Swan neck
- Boutonniere
What is osteoporosis ?
bones become porous due to a loss in bone mass/density (osteopenia) and decrease in bone formation
- known as the “silent disease” because bone loss occurs without signs or symptoms
- leads to increased risk of fractures
- Asians, women, and Caucasians more at risk
What are some uncontrollable & modifiable risk factors of osteoporosis ?
- gender, age, body size, ethnicity, bone fractures
- lack of exercise, low calcium, anorexia nervosa, low estrogen levels, smoking, caffeine, alcohol, medication intake
What are some risk reduction of osteoporosis ?
- increase physical activity; increase calcium and vitamin D intake
- avoid excessive caffeine, alcohol, steroids, smoking
- estrogen replacement therapy; prevent falls
What is osteoarthritis ?
progressive breakdown and loss of cartilage in one or more joints
- degenerative joint disease (DJD)
- caused by wear and tear, and trauma
What are some signs/symptoms of Osteoarthritis ?
- Heberden’s and Bouchard’s node
- joint edema, aching, diffuse pain with movement
- morning stiffness lasts less than 30 mins and decreases with movement
What is gout ?
form of arthritis that develops from an increase in serum uric acid causing crystals of uric acid to deposit in one or more joints
- great toe most common place affected (can also occur in wrists, knees, and ankles)
What are some signs/symptoms of gout ?
sudden and progressively severe onset of redness, pain, and edema in the affected joint
What is hip dysplasia ?
hip socket that doesn’t fully cover the ball portion of the upper thighbone
- allows hip joint to become partially or completely dislocated
- commonly born with it
What is active ROM ?
movement done by client
- should be smooth and painless through its complete range
What is passive ROM ?
examiner moves the relaxed joint through the limits of movement
What are the ROM for cervical spine (head and neck) ?
- flexion
- extension
- hyperextension
- lateral flexion
- rotation
What the ROM for the jaw ?
- open and close
- side to side
- protrude and retract
What is the ROM for the shoulders ?
- forward flexion
- extension and hyperextension
- abduction and adduction
- internal and external rotation
What is the ROM of the thoracic and lumbar spine ?
- flexion
- extension and hyperextension
- lateral bending
- rotation of upper trunk
What is the ROM of the elbows ?
- flexion and extension
- supination and pronation
What is the ROM of the knuckle joint ?
- metacarpophalangeal flexion, extension and hyperextension
What is the ROM of the fingers ?
- flexion (make a fist),extension
- abduction and adduction
- opposition
What is the ROM of the thumb ?
flexion, and extension
What is the ROM of the wrist ?
- flexion, extension, and hyperextension
- radial deviation, and ulnar deviation
What is the ROM of the hips ?
- flexion with knee flexed or knee straight, extension, hyperextension
- abduction, adduction
- internal and external rotation
What is the ROM of the knee ?
- flexion and extension
What is the ROM of the ankle ?
- dorsiflexion, plantar flexion
- inversion, eversion
- abduction, adduction
What is hip dysplasia ?
where the hip socket doesn’t fully cover the ball portion of the upper thighbone
- hip can become partially or fully dislocated
- most are born with this condition
What are some special considerations with children ?
- outward rotation of lower extremities can be normal in kids 2-3.5 yrs
- inward rotation requires further evaluation
- lordosis is most common in AA kids
